Ultimate guide to IVF
What is IVF?
IVF Treatment is like evolution of era in the treatment of infertility. The birth of Louise Browne with the retrieved eggs that were fertilized with husband’s sperm marked the evolution of world’s first test tube baby. After that second success came with the second test tube baby with IVF treatment in India particular in Kolkata region.
This lab procedure was introduced for women with damaged fallopian tubes that could not be repaired. With the advancements this therapy is available for endometriosis, tubo-peritoneal disturbances, pelvic adhesions, PCOD and cases of unexplained infertility. Even the patients with IUI failures can get positive result with this procedure.
IVF means fertilization of egg outside the body that is in the controlled conditions of laboratory.
What Are Options in IVF?
For the intended parents basically there are two options one is Blastocyst another is Laser Hatching
IVF WITH LASER ASSISTED HATCHING
Assisted hatching is performed on the embryo while it is in lab. Before placing it back to female’s uterus, a hole is created in the outer layer of the embryo by laser. With laser hatching, the chances to get pregnant are significantly increased in IVF. Although the quality of embryos remains same.
Laser assisted hatching is a significant procedure for older women who develop embryos with thick wall that complicates the natural hatching. So he chances of success are considerable higher. As only outer layer is handled, the embryo remains safe during the procedure.
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IVF WITH BLASTOCYST TRANSFER
An embryo turns into blastocyst after 5-6 days of insemination. So it has a greater chance for cell division than traditional IVF procedure over thing time. The outer shell of the blastocyst is extremely thin that increases that allows greater opportunity of implantation in the uterus cavity. As the blastocyst consists of a fluid cavity so it is feasible to determine which cells will make a baby while which will create the placenta.
Most of the fertilized eggs will transform into 3 days old embryo, only 40% of the embryos turn into blastocyst. So blastocyst is a selective type of group offering greater possibility to become pregnant.
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Why IVF?
It is preferred when the women do not have uterus but still have ovaries.
Female cannot carry the pregnancy due to some medical problems but can provide egg
Recurrent IVF failures or pregnancy loss
Poor egg quality and uterine problems
When hysterectomy removed from the uterus
Unable to adopt child due to age or marital status
Single parent and gay men
How IVF Takes Place?
INITIAL SCREENING
- Before the procedure during the menstrual cycle hormone estimation has been done like serum AMH, FSH, LH, TSH respectively on the consecutive day of cycle.
- Ovarian cysts, submucous fibroids, endometrial polyps, chocolate cysts and hydrosalpinges are diagnosed with the transvaginal ultrasound.
- After that semen analysis is done to diagnose the fertility problem in male partner and to decide about the ICSI technique which is used for poor sperm motility and low sperm count problem in males.
- In many cases to ensure the uterus is in best form for the acceptance of embryo diagnostic or operative laparoscopy is done.
After the initial screening controlled ovarian stimulation is done to boost the IVF success rates.
OVARIAN STIMULATION
- GnRH (gonadotropin) agonist or a GnRH-antagonist to prevent the pre mature release of eggs before the accurate time of retrieval.
- To stimulate the development of multiple follicles FSH or HMG is induced and to ensure the good quality matured eggs.
- For the final maturity of eggs in the follicles HCG is induced.
Before the ovarian stimulation it must be taken care whether injections are stored in the refrigerator or not? which is important and need to be packed with coolant packs for transaction and for the administration of injections one person must be there so the feasible results of the cycle can be attained.
EGGS RETRIEVAL
Usually eggs collection is done through the vagina wall guided by ultrasound under the short anesthesia in all IVF centers in India. After the collection process women get recover within half an hour.
In the collection process initially the ovaries are scanned through the vagina and then needle is placed through the vagina wall into the ovary. Entire procedure of egg retrieval is of 5-10 minutes.
SPERMS COLLECTION
After the eggs removal next important step is to collect the adequate quantity of sperms and before the collection of semen sample generally abstinence for more than 2 days is recommended. Even new techniques have showed that just one hour abstinence can also work and can give better quality of sperms.
Sperm freezing is also done in few cases if the patient cannot give semen sample on the egg collection day due to any reason. In some cases frozen sperms are also provided as donor sperms for the successful IVF cycle.
EGG FERTILIZATION
After the eggs removal next important step is to collect the adequate quantity of sperms and before the collection of semen sample generally abstinence for more than 2 days is recommended. Even new techniques have showed that just one hour abstinence can also work and can give better quality of sperms.
Sperm freezing is also done in few cases if the patient cannot give semen sample on the egg collection day due to any reason. In some cases frozen sperms are also provided as donor sperms for the successful IVF cycle.
EMBRYO TRANSFER
It is simple yet the important step of IVF cycle and must be done with proper care. This procedure is done in small time and painless so done without any sedation and anesthesia. In few cases if patient feels nervous or uncomfortable due to vaginal manipulation then anesthesia can be given.
With the help of ultrasound machine embryo transfer procedure is done in which small speculum is introduced in the vagina for the uterus’s mouth exposure. With the catheter embryo is implanted in the uterus.
AFTER EMBRYO TRANSFER
Patient is monitored regularly after the embryo transfer and asked to have some precautions and bed rest so the IVF success can be optimized. After 14 days of embryo transfer women can go for pregnancy test to ensure the success of cycle. In case of negative result of pregnancy test repeated IVF cycle can be performed for successful conception.
On average basis after 2-3 cycles couples get conceive successfully however various factors can affect the success rates. So it is important to consult the best IVF doctor so the best treatment with least IVF cost can be received.
Process of IVF
What are Success Rates in IVF?
Chances for the successful pregnancy in IVF procedure are considerably more with our centre. However the chances of success in the positive pregnancy rely on the various factors but the most important factor is art, talent and experience of the IVF doctor you have chosen for your ivf procedure.
